DPH commissioner: Mass. may reconsider following Trump Administration vaccine policies
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Moderna's COVID-19 vaccine
As turmoil engulfed a federal vaccine advisory panel earlier this month, Massachusetts Department of Public Health Commissioner Robbie Goldstein urged his own set of advisors to stay open-minded while also hinting at the possibility of disentangling state policy from the Trump administration.
That philosophy could be tested later Wednesday and Thursday, as the CDC's revamped Advisory Committee on Immunization Practices (ACIP) meets and reviews a vaccine ingredient that U.S. Health and Human Health Services Secretary Robert Kennedy Jr. has previously -- and, experts say, erroneously -- linked to conditions like autism. Kennedy fired all 17 ACIP members on June 9 and made eight new appointments days later.
The Massachusetts Vaccine Purchasing Advisory Council (MVPAC) orients its work closely around guidance from the ACIP. At its recent meeting, Goldstein acknowledged the upheaval at the federal panel has been "in some ways, very alarming."
"I guess I want to say to this group that's here that I think it is our responsibility to keep an open mind about what is happening, to analyze the data as they're presented to ACIP, to think like an ACIP member in the next two weeks, and to use this body to have our own deliberation and our own discussion," Goldstein said on June 12. "I don't think it's appropriate for us to jump to conclusions that what ACIP decides at the end of June is necessarily wrong or necessarily right. I think it's our responsibility to look at the data that are presented, to listen to the deliberation, and to come to our own conclusions -- and they may be the same."
Kennedy said he chose to do a "clean sweep" and reconstitute the panel "to reestablish public confidence in vaccine science." The secretary later wrote on social media that his new appointees include "highly credentialed scientists, leading public-health experts, and some of America's most accomplished physicians."
Goldstein pointed out one of those new members is Dr. H. Cody Meissner, a professor of pediatrics and medicine at the Dartmouth Geisel School of Medicine, who also happens to be on the MVPAC.
"I think Dr. Meissner has shown a commitment to the science, a commitment to evidence, a commitment to vaccine policies that protect the commonwealth, protect people across this country," Goldstein said. "And so I'm hopeful that there are more like him on the advisory committee as it is repopulated."
One of the dismissed ACIP members was Dr. Lin Chen, an associate professor of medicine at Harvard Medical School and director of the Travel Medicine Center at Mount Auburn Hospital.
Sen. Elizabeth Warren, in a letter to Kennedy on Tuesday, said the panel's new members "include vaccine skeptics, medical professionals with conflicts of interest, and individuals without any apparent experience conducting studies of vaccines, counseling patients about vaccines, or administering vaccines."
"As presently constituted, the committee lacks the qualifications and credibility to offer the nation credible advice on vaccines," Warren wrote.
The ACIP's role is to make recommendations about vaccine safety, efficacy and clinical need to the U.S. Centers for Disease Control and Prevention, according to HHS.
Meanwhile, the MVPAC's mission is to help DPH distribute ACIP-recommended childhood vaccines "to ensure the health and safety of the Commonwealth's citizens." Some members are designated by DPH, the Center for Health Information and Analysis, the Massachusetts Academy of Pediatrics, the Massachusetts Medical Society and health insurers.
The MVPAC makes its purchasing recommendations using principles such as safety and efficacy, cost and supply issues, provider and patient issues, and market share, according to the body's guiding principles. Aiming to "maximize vaccine coverage and minimize provider confusion, vaccine waste and administration errors," the MVPAC says it also "will avoid to the degree possible making significant changes to their periodic purchasing recommendations except as indicated by their careful assessment of the factors outlined in these principles."
Before coming to DPH, Goldstein worked as a senior policy advisor at the CDC during the COVID-19 pandemic.
Goldstein said state public health officials have been working to gauge how Massachusetts fits into the "complicated federal landscape," including within the legal and regulatory arena.
"So what laws, what regulation do we have here in Massachusetts that either tie us to CDC recommendations and ACIP, or may need to be amended to make sure that we can use evidence and science to drive our decisions and our recommendations," the commissioner said.
"The work falls into a second bucket, which is how do we maintain access and purchase ability for these vaccines," Goldstein continued. "And we are making sure that, no matter what happens at the federal level, we will continue to be able to purchase vaccines here in Massachusetts, distribute them across the commonwealth, and make sure there's access in pediatrics practices, community health centers, hospitals all across the state."
Gov. Maura Healey, asked Monday how Massachusetts may need to extricate itself from federal vaccine policy, said Goldstein and DPH are evaluating the matter.
"We're going to continue to provide vaccinations here in Massachusetts," Healey told reporters.
Kennedy last month announced the CDC is no longer recommending COVID vaccines for healthy pregnant women and children. Goldstein has emphasized COVID shots remain available, and they can prevent serious illness and death for at-risk individuals.
The ACIP is meeting at CDC headquarters in Atlanta, with opening remarks slated for 10 a.m. Wednesday.
"The work prior to an ACIP meeting is extensive, and the amount of data that are evaluated by working groups and presented to the full committee is enormous," Goldstein had said earlier in June. "I am interested to see, at the end of this month, brand new members of ACIP that are able to make informed decisions about vaccine policy."
A previous agenda for this week's ACIP meeting listed votes on vaccine recommendations for COVID, RSV and flu shots, among other immunizations. The finalized itinerary scraps some votes, and includes a presentation about thimerosal in vaccines and recommendations about the ingredient in flu shots.
Kennedy wrote a book in 2014 about the dangers of thimerosal, which the CDC and health experts have debunked, according to Politico. In her letter, Warren called the ACIP's planned vote on thimerosal-containing vaccines a "dog whistle for vaccine skeptics."
As questions swirl around pending federal recommendations and how the public will react to Kennedy's updated panel, Goldstein emphasized the role of MVPAC in promoting trust in vaccine policy.
"I cannot say this enough, that the damage that is done when people in the federal government talk about vaccines with mis- and disinformation, when they share fringe theories about vaccines, the damage that is done to trust in public health and vaccine programs is enormous," Goldstein said, without invoking specific individuals or examples. "I have been trying to use my position to speak about the benefits of vaccines as much as I possibly can. I think that we need to continue to do so -- all of us."
Healey called Kennedy a "threat to public health" during the Health Equity Trends Summit earlier this month. She described engaging with the federal government as playing "opposite day" with children.
"If they want to defund science and research, we will fund science and research," Healey had said, drawing audience applause and cheers. "If they want to dismantle the CDC and vaccine infrastructure, we're going to find a way to build, and make, and distribute our own, and we're going to make sure people have access to it equitably."
Colin A. Young contributed reporting.
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